An Association Between C-Reactive Protein Levels and the Occurrence of Cognitive Dysfunction After Heart Valve Replacement

• Published in: Vascular health and risk management 2021-01, Vol.17, p.713-720
• Main Authors: Nurcahyo, Widya Istanto, Arifin, Anshoril, Primatika, Aria Dian, Muttaqin, Zainal, Elfira Boom, Cindy, Harahap, M Sofyan, Mochamat, Mochamat, Nugroho, Taufik Eko, Wicaksono, Satrio Adi
• Format: Article
• Language: English
• Subjects: Analysis; Anesthesia; C-Reactive Protein; Cardiac patients; cardiac surgical procedure; Cardiac Surgical Procedures - adverse effects; Cognition; Cognition disorders; Cognitive ability; cognitive dysfunction; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - etiology; Cytokines; Fentanyl; Heart surgery; Heart Valve Prosthesis Implantation - adverse effects; Heart Valves; Humans; Inflammation; Laboratories; Medical research; Medicine, Experimental; Original Research; Patients; postoperative complication; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Proteins; Receptors, Immunologic - metabolism
• ISSN: 1178-2048; 1176-6344; 1178-2048
• DOI: 10.2147/VHRM.S334982

Postoperative cognitive dysfunction (POCD) is defined as cognitive dysfunction related to inflammation after surgical procedures, which is common following cardiac surgery. Cognitive deficits are thought to result from a systemic inflammatory response. C-reactive protein (CRP) and other proinflammatory cytokines, which are released in response to inflammation, disrupt the blood-brain barrier and neurotransmission, resulting in POCD. This study aimed to determine the correlation between POCD and increased levels of CRP in patients who had undergone heart valve replacement. This study comprised 32 patients with normal cognitive function undergoing heart valve replacement. The CRP levels were measured before surgery and on the second postoperative day, and cognitive function was examined via the Indonesian-adapted Montreal Cognitive Assessment (MOCA-INA) on the third postoperative day. Data were analyzed using Spearman correlation test. Of the 32 patients, 28 (87.5%) experienced POCD. The median level of CRP was 6.6 mg/dL (interquartile range: 4.0, 8.3 g/dL). According to Spearman correlation test, increased levels of CRP were significantly related to POCD following heart valve replacement (p = 0.003, r = 0.501). The receiver operating characteristic curve indicated that the CRP cutoff level was 3.345 mg/dL, and the sensitivity and specificity were 89.3% and 75%, respectively. High expression level of CRP was correlated with POCD following heart valve replacement.